LASEK

LASEK is short for Laser Epithelial Keratomileusis and is similar to LASIK, except that the surgeon cuts a flap in the epithelium (the cornea's outer layer of cells) only, instead of through the epithelium and part of the stroma.

He or she then loosens the edges of the flap with alcohol. LASEK is used mostly for people with thin or flat corneas who are poor candidates for LASIK, which requires more corneal tissue for success. It is a relatively new procedure; drawbacks include more discomfort afterward and a slightly longer healing time than for LASIK.

LASEK is technically a variation of PRK (Photorefractive Keratectomy). Also called epithelial LASIK or E-LASIK, LASEK is used mostly for people with corneas that are too thin or too flat for LASIK. It was developed to reduce the chance of complications that occur when the flap created during LASIK is not the ideal thickness or diameter.

In LASEK, the epithelium, or outer layer of the cornea, is cut not with the microkeratome cutting tool used in LASIK, but with a finer blade called a trephine. Then the surgeon covers the eye with an alcohol solution (perhaps one part alcohol and four parts sterile water) for around 30 seconds. The solution loosens the edges of the epithelium.

After sponging the alcohol solution from the eye, the surgeon uses a tiny hoe to lift the edge of the epithelial flap and gently fold it back out of the way. Then he or she uses an excimer laser, as in LASIK or PRK, to sculpt the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye with a kind of spatula.

In many ways, what you can expect from LASEK is similar to what you can expect from LASIK, but there are some differences. According to doctors who perform LASEK, the flap edge heals in about a day, though patients usually wear a bandage contact lens for around four days. You may feel eye irritation during the first day or two afterward. Also, the time it takes to recover good vision is often longer — up to four to seven days. Of course, it varies from one person to the next.

If you are considering LASIK, but your doctor says you need LASEK instead, ask why. It's not for everyone, but many surgeons who perform LASEK consider it a better option for some patients who will probably not do very well with LASIK.